1. Field of the invention
This invention relates generally to devices for suturing tissue and more specifically for such devices which are adapted for percutaneously suturing tissue within a body cavity.
2. Discussion of the Prior Art
In the past, suturing has been used to join two pieces of tissue typically in an open surgery environment. In such an environment, visualization and access to the pieces of tissue is generally of little concern. A needle with an attached suture is grasped by a scissor clamp and inserted through the tissue pieces. The clamp disengages the needle on one side of the pieces and grasps the needle on the other side of the pieces to draw the suture through the tissue. Opposing ends of the suture (line) are then joined to form the suture.
With the advent of less invasive surgeries, it has become desirable to form sutures on the interior side of a body wall, such as the abdominal wall, and within a body cavity, such as the abdominal cavity. Under these circumstances, the suture line must be inserted through the abdominal wall and the tissue pieces within the abdominal cavity. The (free) end of the suture line must then be engaged and joined to the opposing end of the suture line to form the suture around the two pieces within the body cavity. This percutaneous suturing has been preformed with a suture line apparatus which can be sharpened to form a needle which is then inserted directly through the body wall. Alternatively, the percutaneous suturing device can be adapted for insertion through a trocar providing access across the body wall. Whether inserted directly through the body wall or through a trocar, the device engages the tissue pieces interiorly of the body cavity and issues the suture line through the needle.
In the past, a separate device in the nature of a retractor has been inserted percutaneously to grasp the free end of the suture line. The opposing ends of the suture line are then joined to form the suture around the tissue pieces. In some cases, both the suture line device and the retractor have been removed through a common hole in the body wall and the suture knot has been formed exteriorly of the body wall. The knot has been then pushed through the common opening to form the suture around the tissue pieces interiorly of the body cavity.
In the case of these devices of the prior art, the formation of a single suture has been very complex involving several instruments and at least two hands. The visualization of the complex formation of the suture has been a problem requiring even further apparatus and manipulation to accommodate the procedure.